Provider Demographics
NPI:1518213628
Name:ARTHUR, BETHANY MORAE
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:MORAE
Last Name:ARTHUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5456 RUSSO DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95118-3048
Mailing Address - Country:US
Mailing Address - Phone:408-893-3130
Mailing Address - Fax:
Practice Address - Street 1:2117 CURTNER AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-1308
Practice Address - Country:US
Practice Address - Phone:408-893-3130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-26
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health